Susie is a 45 year old mother to 4 children. She works three 12 hour shifts per week as a ICU nurse and 132 hours per week as a mom. Susie has a long family history of dementia, diabetes, joint degeneration and obesity. Ever since her last child, Susie has been on a quest to lose the 20 pounds she gained during the pregnancy. She has tried every diet at least once and even some diet products including weight loss powders and teas. Her days are LONG and very mentally active, juggling numerous responsibilities and tasks. Her work is stressful and demands that she skip meals most work days. She typically only gets in one meal per shift. She breaks her hunger by grabbing a piece of chocolate or drinking a diet coke. Three days per week she may only consume 800 calories per day but she is still struggling with her weight. Susie is frustrated.
Today is Susie’s third week of intermittent fasting where she eats between the hours of 12pm and 8pm on her non-work days and sticks with one meal on work days. She learned about the strategy from her friend Jane, a fellow nurse who is in her 20s. Jane told Susie that it is a fast way to improve brain fog, increase energy and reduce body fat. Susie’s friend does not have children, lives with her fiance and spends her free time hiking with her dogs or gardening. Susie wanted the same clear thinking, fat loss and better sleep that Jane was experiencing so she is giving it a try. At three weeks in, Susie has not lost any weight but has increased brain fog, agitation from being hungry and finds herself unable to stop eating once she starts when she is at home.
Does this sound familiar?
Intermittent fasting has been massively popularized in recent years because of its claims to move the needle on weight loss which is unfortunately typically the hallmark of health for many women, including Susie. But I am here to convince you today, that the typical intermittent fasting strategy of skipping breakfast could cause more harm than good. This is especially true if you are a woman in your mid-40’s whose days are jam packed and you are already challenged to eat sufficient amounts of nutrients each day. Before we dig into the power of breakfast, let’s look at Susie’s world one more time from the perspective of stress.
Susie’s days are literally jammed with non-stop tasks as a mom to two teenagers and two pre-teens. All meals are typically on-the-go or eaten while in the process of doing something else. Susie’s work as an ICU nurse used to be rewarding and “filled her cup” but now is draining and extremely stressful. She has a difficult time coming down out of fight or flight upon returning home which cuts into her sleep, energy to exercise or even find time to cook. Can you see how the added stress of restricting food via intermittent fasting will only further drain Susie’s tank further?
“Most studies in humans have shown that intermittent fasting (whether via alternate-day-fasting or a time-restricted feeding period) doesn’t provide any additional benefit compared to other diets, with metabolic and cardiovascular benefits attributable solely to the weight lost during the study. The advantage of intermittent fasting is that it’s a structure that helps many people cut calories that doesn’t feel too restrictive. But like so many diets, it comes at a significant health cost." (1)
Remember that Susie’s main goals to achieve with intermittent fasting include improving brain fog, increasing energy and reducing body fat. Now combine these three goals with the context of Susie’s world and the science that points to the “significant health cost” that intermittent fasting comes with. Now, let’s dig into the power of breakfast for Susie.
Susie’s latest symptoms of agitation and insatiable appetite once she breaks her fast are directly linked to her body’s stress response increasing as a result of her intermittent fasting. A 2015 study showed that women who regularly skipped breakfast had disrupted cortisol rhythm, hypothalamic-pituitary-adrenal axis overactivation and elevated blood pressure even though they had the same levels of perceived stress as the women who always ate breakfast. (2)
So why is Susie having all of these symptoms of increased stress and her friend Jane appears to be thriving with her new change? Consider Susie’s total allostatic load (the cumulative burden of chronic stress and life events) versus Jane. Susie’s cup was already flooding over. The stress of pushing herself through a fast, which further depleted her already dwindling cortisol levels, during busy mornings as a mom and in an intense work environment was now being represented in the symptoms she was feeling. Jane’s world is much different than Susie’s world. Susie does not have a chance to recover and rebuild. She is a caretaker at home and work which does not leave her much space to take care of her own health.
Susie needs to dampen the stress response as a chronic state of being and help to regulate her stress output. There is also another red flag with Susie’s chosen strategy, her family history of type 2 diabetes. Skipping breakfast 4 to 5 times per week increases your risk of developing type 2 diabetes by a whopping 55%. Studies routinely show that eating breakfast is super beneficial for our health! A 2019 meta-analysis showed that people who never skip breakfast have a 22% increased risk of developing type 2 diabetes than people who eat breakfast every day, even after accounting for BMI. (3) These studies give point to an alternative strategy for Susie…eat breakfast.
Using Nutrivore principles, here are some breakfast ideas that will also help Susie achieve her goals of reduced brain fog (aka, brain health), increased energy and reduced body fat. Susie would start her day with a nourishing meal within two hours of waking. Protein would be the main focus of the meal as this is the macronutrient that supports blood sugar stability and mental sharpness. She would also want a good source of fiber, Vitamin C, B-vitamins and Omega 3 fatty acids.
Meal Idea # 1
Crockpot Beef Inside round roast
Lentils
2 Eggs
Grapefruit
*Susie would start the roast Monday morning and steam the lentils Monday morning. She could jazz it up or keep it simple. This rotation could last her Tuesday, Wednesday and Thursday.
Meal Idea # 2
Sauteed Spinach
*Susie could shop for these ingredients on Thursday and have this meal Monday morning. She could use left over ingredients for lunches/dinners.
Meal Idea # 3 for work mornings (Fri-Sun)
Quinoa with Swiss chard and onions
*Susie could put these meals together 3 days in advance so she could just grab the whole pyrex and take it with her OR sit down and eat before heading out the door.
After 23 years as a fitness professional, a mom to two sets of twins and a year and a half until I am an RN, this post is very near and dear to my heart. I see way too many women in their 40s attempting to apply strategies to their overfilled plate that only increase stress. Eating breakfast is another tool that we have to nourish our body, provide it with the nutrients it needs to build muscle, support hormonal regulation and dampen the stress response. Women need strategies that aim to support more than the health goal of weight loss. They need strategies to promote healthspan and wellness in all domains of life. In order to accomplish that, we need to apply foundational principles consistently, breakfast is just one of those principles.
Susie is building habits that will not only help her reach her goal of increasing her energy but she is setting herself up for even better hormonal regulation as well!
SOURCES:
(1) Witbracht, M., Keim, N. L., Forester, S., Widaman, A., & Laugero, K. (2015). Female breakfast skippers display a disrupted cortisol rhythm and elevated blood pressure. Physiology & behavior, 140, 215–221. https://doi.org/10.1016/j.physbeh.2014.12.044
(2) Ballon, A., Neuenschwander, M., & Schlesinger, S. (2019). Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. The Journal of nutrition, 149(1), 106–113. https://doi.org/10.1093/jn/nxy194
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